DOCSLIB.ORG

Service Specification: High Secure Mental Health Services (Adult)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Service Specification: High Secure Mental Health Services (Adult) SCHEDULE 2 – THE SERVICES A. Service Specifications Service Specification 1752 No: Service Adult High Secure Services Commissioner Lead For local completion Provider Lead For local completion 1. Scope 1.1 Prescribed Specialised Service 1.1.2 This specification covers the provision of high secure services for adults aged 18 years and over in England and Wales and the high secure service for women in Scotland and Northern Ireland. There will be exceptional circumstances where under 18’s will require admission to high secure services; a separate protocol covers this situation and is included in Appendix 5. 1.1.3 The high secure service for men in Scotland is not covered by this specification. 1.2 Description 1.2.1 This service specification describes high secure inpatient services for adults delivered within a clearly defined geographical area at multi- regional level in line with nationally agreed population catchment areas. This specification will be subject to review 3 years after publication. 1.3 How the Service is Differentiated from Services Falling within the Responsibilities of Other Commissioners 1.3.1 NHS England commissions adult secure mental health services and associated non-admitted care, including access assessment and the 1 | Page High Secure Women’s Outreach service (see 4.1.4) for those detained under the Mental Health Act. 1.3.2 The Secretary of State for Health has a duty under Part One, Section 4 of the National Health Service Act 2006, to provide hospital accommodation and services for persons who: • are liable to be detained under the Mental Health Act 1983 (c20) and • in the opinion of the Secretary of State require treatment under conditions of high security on account of their dangerous, violent or criminal propensities. 1.3.3 Only NHS Trusts approved by the Secretary of State through a formal authorisation process can provide high secure services as detailed in Part One of the National Health Service Act 2006. Such approval must be for a specified period, may be subject to conditions and can be amended or revoked at any time. 1.3.4 There are three designated NHS Trusts authorised by the Secretary of State to provide high secure services: these are listed in Section 6. 1.3.5 The three hospitals provide the following high secure services: • Services for people who are Deaf (Rampton Hospital) • Male mental illness (Broadmoor, Rampton and Ashworth Hospitals) • Personality Disorder services (Broadmoor, Rampton and Ashworth Hospitals) • Learning Disability Services for men (Rampton Hospital only) • Women’s Service (Rampton Hospital) 1.3.6 High secure services are provided in hospitals whose physical security arrangements are equivalent to a Category B prison; they can however, treat individuals who in a prison setting would be in a Category A environment. 1.3.7 High secure hospitals are subject to the High Security Psychiatric Services (Arrangements for Safety and Security) Directions 2019, which outline requirements concerning safety, security and the management of patients. The 2019 Directions can be accessed through the following link 2 | Page https://www.gov.uk/government/publications/high-security-psychiatric- services-directions-2019-arrangements-for-safety-and-security 1.3.8 The high secure hospitals must adhere to the Clinical Security Framework and will engage with the Clinical Secure Practice Forum (CSPF) and the National Oversight Group (NOG), which provides line of sight for the Secretary of State for Health. 1.3.9 The high secure hospitals will work collaboratively to achieve consistency in application of policies and practice for high secure mental health services to ensure there are equitable services for patients regardless of which hospital the patient resides in. 1.3.10 Clinical Commissioning Groups (CCGs) commission services for adults on the secure pathway who do not or no longer require high, medium or low secure care or Forensic Outreach Liaison Services all of which are commissioned by NHS England. 2 Care Pathway and Clinical Dependencies 2.1 Care Pathway 2.1.1 Secure services provide treatment for adults aged 18-years and over with mental disorders, these include mental illness (MI), personality disorder (PD) and neurodevelopmental disorders (NDD) including learning disabilities (LD) and autism. Further detail regarding the care pathway and service expectations is set out in Appendix 1. 2.1.2 Secure services also provide care and treatment for people who are • culturally deaf (D) and audiologically deaf (deaf) • have an acquired brain injury 2.1.3 Patients in secure services are liable to be detained under the Mental Health Act and their risk of harm to others and risk of escape from hospital cannot be managed safely within other mental health settings. 2.1.4 Patients in secure services typically have complex chronic mental disorders, which are linked to offending or seriously harmful behaviour. Some will be involved with the criminal justice system (CJS), courts and prison, and may have Ministry of Justice (MoJ) restrictions imposed. 3 | Page 2.1.5 Three levels of security currently exist across secure adult inpatient services each of which provides a range of physical, procedural and relational security measures to ensure effective treatment and care whilst providing for the safety of the patient and others including patients, staff and the general public. • High Secure services provide care and treatment to those adults who present a grave risk of harm to others and who cannot be managed in lower levels of security and who must not be able to escape from hospital • Medium secure services provide care and treatment to those adults who present a serious risk of harm to others and whose escape from hospital must be prevented • Low secure services provide care and treatment who present a significant risk of harm to others and whose escape from hospital must be impeded 2.1.6 All high secure patients will be detained under the Mental Health Act and the decision to admit will be based on a comprehensive psychiatric assessment and assessment of risk. Many, but not all patients admitted to high secure services will have been charged with or convicted of a violent criminal offence. 2.1.7 High secure services play a key role in assessing an individual’s ability to participate in court proceedings and in providing advice to courts regarding disposal following sentencing. 2.1.8 The recognised pathways into high secure care are as a step up from medium secure care, admission directly from the criminal justice system including transfers from prison or more rarely, a step up from other services. 2.1.9 The core objectives of high secure services are to assess and treat mental disorder, reduce the risk of harm towards others and to support recovery and rehabilitation. The aim is for patients to safely transition to lower levels of security (e.g. medium or low secure services) or to be returned to prison. It is rare that patients are discharged from high secure services directly to community settings. 2.1.10 The pathway through and out of secure care must be identified early in admission though may be subject to change depending on changing needs or circumstances. The care pathway must be planned in consultation with the patient. Lengths of stay are typically between five and six years. 4 | Page 2.1.11 High secure care will operate within an ethos that places the patient at the centre of their care and facilitates active engagement in their recovery from mental disorder and risky behaviours. 2.1.12 Multi-disciplinary team (MDT) care will underpin delivery; the MDT will consist of appropriately trained skilled and supervised staff including psychiatrists, clinical and/or forensic psychologists, mental health nurses, occupational therapists, pharmacists, social workers and other therapists including art and speech and language therapists. 2.1.13 High secure services will ensure that patients are able to access and receive appropriate services to identify and meet physical health care needs. Appendix 1 sets out more detail about requirements for the provision of pharmacy and primary healthcare services and access to secondary healthcare services. 2.1.14 Details about the service model, acceptance and exclusion criteria and care pathway are set out in Appendix 1. 2.2 Interdependence with other Services 2.2.1 High secure services are part of a spectrum of services whose function is to meet the needs of patients with mental disorders and/or neurodevelopmental disorders including learning disability and autism that will benefit from specialist care and treatment within a secure environment. 2.2.2 Key partnerships include: • Care Quality Commission • NHS England • NHS Improvement • Medium secure and low secure services • NHS / Independent / Third Sector providers • Advocacy Services • Carer Support Services • Department of Health (DH) • Ministry of Justice (MoJ) • Courts • Police • Her Majesty’s Prison and Probation Service (HMPPS) • Multi Agency Public Protection Arrangements (MAPPA) • Health and Justice commissioned offender health services 5 | Page • Offender Personality Disorder Services • Social Care Agencies • Appropriate Regulators 2.2.3 The service must have Caldicott and information governance compliant protocols and structures in place to enable the appropriate sharing of clinical information with other agencies. 2.2.4 High secure services must provide training and education programmes and should participate in research/development activity which promotes the continual improvement of the service and outcomes for patients. 2.2.5 In addition, they must ensure that the patients in their service have access to participate in research activity. The service should ensure that all staff are able to participate in these activities without affecting care and treatment or business continuity. 3 Population Covered and Population Needs 3.1 Population Covered by This Specification 3.1.1 This service specification relates to adults aged 18 and over who are the commissioning responsibility of NHS England including adults from Wales and women from Scotland and Northern Ireland who require high secure services.
Load more

Recommended publications
  • Notes on the Culture of Broadmoor and Other Special Hospitals, Comparison with Traditional Psychiatric Hospitals and the Likely
    Notes on the culture of Broadmoor and other special hospitals, comparison with traditional psychiatric hospitals and the likely problems of whistle-blowing and diagnostic overshadowing within these cultures Diane Carpenter, University of Southampton Introduction These notes have been selected from a wider bibliography as they appear to encapsulate the relevant cultures under examination. The sources are briefly addressed in the text or footnotes. Following the examination of hospital cultures I have included a timeline to help with contextualization. Any outstanding questions I shall endeavour to address in person. The accompanying PowerPoint presentation summarises the issues that these extracts support. Culture in special hospitals / Broadmoor The following list provides examples of the culture within Broadmoor for the period c. 1970s- 1981.1 Its source was based on the evidence of former staff and patients and was televised before publication in book form. Whilst no source is completely without its bias, it is arguably important to take account of the recollections of those who may not traditionally have had a voice. These accounts may then be compared with the findings of official inquiries – where accusations have equally been levelled of bias towards the staff and the system. Accusations by patients of staff pilfering visitor’s gift. Key culture: keys represent power Admission procedure (described by Goffman as a ritual) involved stripping, bathing and isolating new patients). [Different in traditional psychiatric hospitals – there patients would receive a thorough physical examination to eliminate differential diagnoses, but otherwise joined other patients]. Diagnoses withheld from patients who are desperate to know what is wrong with them.
    [Show full text]
  • Wsn 22 (2015) 108-119 Eissn 2392-2192
    Available online at www.worldscientificnews.com WSN 22 (2015) 108-119 EISSN 2392-2192 Gender, Masculinity, Contemporary History and the Psychiatric Secure Estate: Back to the Future? Jason L. Powell* and Paul Taylor University of Chester, Parkgate Road, Chester, CH1 4BJ, United Kingdom *E-mail address: [email protected] ABSTRACT In contemporary history, the use of gendered treatments for women with mental health issues in the psychiatric secure estate is an issue of major concern in Great Britain. This paper examines women and gender in the psychiatric secure estate from a structural analysis drawing influence from Connell’s (1987) theoretical and conceptual work on hegemonic masculinity. Bio-psychological approaches have almost dominated academic discussion in relation to women’s incarceration and there is an reflexive need to develop other sociological frameworks on hegemonic masculinity because dominant bio-psychological models have failed to identify underlying configurations which combine to oppress women whilst simultaneously reproducing consequences of masculinity and power within institutional structures. Keywords: bio-psychology, power, gender, secure units, masculinity 1. INTRODUCTION The relationship between women and mental illness/disorder is complex and multifaceted. It has a long history. This relationship is constructed through multiple forces, and it’s nature and character comes to be known through three primary themes; discursive World Scientific News 22 (2015) 108-119 controls shaping the relationship, legal responses to female offending and the administrative management of women said to be suffering with diagnosed mental illness and disorders. The culmination of discursive, legal and administrative behaviours render the female subject to sanctions and societal opinions which continue to mis-recognise women who seriously or violently offend beyond bio-medical paradigms.
    [Show full text]
  • Theory of Mind and Mentalizing Ability in Antisocial Personality Disorders with and Without Psychopathy
    Psychological Medicine, 2004, 34, 1093–1102. f 2004 Cambridge University Press DOI: 10.1017/S0033291704002028 Printed in the United Kingdom Theory of mind and mentalizing ability in antisocial personality disorders with and without psychopathy M. D O L A N* AND R. F U L L A M University of Manchester, UK; Bolton Salford and Trafford Mental Health NHS Trust, UK; the Edenfield Centre, Bolton Salford and Trafford Mental Health NHS Trust, UK ABSTRACT Background. The literature on Theory of Mind (ToM) in antisocial samples is limited despite evidence that the neural substrates of theory of mind task involve the same circuits implicated in the pathogenesis of antisocial behaviour. Method. Eighty-nine male DSM-IV Antisocial Personality Disordered subjects (ASPDs) and 20 controls (matched for age and IQ) completed a battery of ToM tasks. The ASPD group was categorized into psychopathic and non-psychopathic groups based on a cut-off score of 18 on the Psychopathy Checklist: Screening Version. Results. There were no significant group (control v. psychopath v. non-psychopathic ASPD) dif- ferences on basic tests of ToM but both psychopathic and non-psychopathic ASPDs performed worse on subtle tests of mentalizing ability (faux pas tasks). ASPDs can detect and understand faux pas, but show an indifference to the impact of faux pas. On the face/eye task non-psychopathic ASPDs showed impairments in the recognition of basic emotions compared with controls and psychopathic ASPDs. For complex emotions, no significant group differences were detected largely due to task difficulty. Conclusions. The deficits in mentalizing ability in ASPD are subtle.
    [Show full text]
  • Mersey Care NHS Foundation Trust Newapproachcomprehensive Core
    Good ––– Mersey Care NHS Foundation Trust High Secure Services: Ashworth Hospital Quality Report V7 Building Kings Business Park Prescot Liverpool L34 1PJ Date of inspection visit: 20 March 2017 to 23 March Tel: 0151 473 0303 2017 Website: www.merseycare.nhs.uk Date of publication: 19/10/2017 Locations inspected Location ID Name of CQC registered Name of service (e.g. ward/ Postcode location unit/team) of service (ward/ unit/ team) RW404 Arnold Ward Blake Ward Carlyle Ward Dickens Ward Forster (Newman) Ward Gibbon Ward Ashworth Hospital Johnson Ward L31 1HW Keats Ward Lawrence Ward Macaulay Ward Ruskin Ward Shelley Ward Tennyson Ward 1 High Secure Services: Ashworth Hospital Quality Report 19/10/2017 Summary of findings This report describes our judgement of the quality of care provided within this core service by Mersey Care NHS Foundation Trust. Where relevant we provide detail of each location or area of service visited. Our judgement is based on a combination of what we found when we inspected, information from our ‘Intelligent Monitoring’ system, and information given to us from people who use services, the public and other organisations. Where applicable, we have reported on each core service provided by Mersey Care NHS Foundation Trust and these are brought together to inform our overall judgement of Mersey Care NHS Foundation Trust. 2 High Secure Services: Ashworth Hospital Quality Report 19/10/2017 Summary of findings Ratings We are introducing ratings as an important element of our new approach to inspection and regulation. Our ratings will always be based on a combination of what we find at inspection, what people tell us, our Intelligent Monitoring data and local information from the provider and other organisations.
    [Show full text]
  • Research Branch Direction De La Recherche Corporate Development Développement Organisationnel
    Research Branch Direction de la recherche Corporate Development Développement organisationnel Persistently Violent (Non-Sexual) Offenders: A Program Proposal Persistently Violent (Non-sexual) Offenders: A Program Proposal Prepared by: David Robinson Research Division Correctional Research and Development Correctional Service of Canada This report is also available in French. Ce rapport est également disponible en français. Veuillez vous adresser au Secteur de recherche et développement, Service Correctionnel du Canada, 340 avenue Laurier ouest, Ottawa (Ontario) KlA OP9. Should additional copies be required they can be obtained from Correctional Research and Development, Correctional Service of Canada, 340 Laurier Ave., West, Ottawa, Ontario, KlA OP9. November 1995 Research Report No R-42 1 Table of Contents PERSISTENTLY VIOLENT (NON-SEXUAL) OFFENDERS: A PROGRAM PROPOSAL 1 Table of Contents 2 Executive Summary 4 Introduction 5 Conceptual Model 7 Assessment9 Treatment Targets 10 Treatment Responsivity 11 Treatment Gain 11 Consultation Group 12 Program Design 12 Selection of Candidates 13 Site Selection 14 Qualifications of Staff 14 Program Description and Duration 15 Sample Size 15 Overview of Treatment Programs 16 Research Framework 16 Summary 19 References 20 Appendix A Treatment Targets and Suggested Testing 24 Appendix B Responsivity Factors 25 Appendix C Admission Criteria and Program Rules 26 Figure 1 Research Design Flow Chart 27 Figure 2 Anger and Emotions Management Program 28 Figure 3 Cognitive Mediation Program Content Areas 29 Acknowledgments 30 2 Executive Summary This proposal outlines relevant treatment targets and presents a research framework to evaluate a program for persistently violent (non-sexual) offenders. The proposed program is compatible with existing Correctional Service of Canada programs, but is more intensive than most, reflects an alternate conceptual framework which has been employed in other settings, and has a rigorous assessment component.
    [Show full text]
  • Curriculum Vitae of STEPHEN DAVID HART
    Curriculum Vitae of STEPHEN DAVID HART Department of Psychology Phone: +1 (778) 782 3354 Simon Fraser University Fax: +1 (778) 782 3427 8888 University Drive Email: [email protected] Burnaby, British Columbia Web: www.sfu.ca/psyc/faculty/hart Canada V5A 1S6 Scholar Identification ResearcherID: www.researcherid.com/rid/D-3908-2013 (D-3908-2013) ORCID: orcid.org/0000-0002-1027-6081 (0000-0002-1027-6081) Google Scholar: scholar.google.com/citations?user=dJpmwisAAAAJ&hl=en&oi=sra Scopus: www.scopus.com/authid/detail.uri?authorId=7202601274 ResearchGate: www.researchgate.net/profile/Stephen_Hart4 Education Ph.D., University of British Columbia (1993) Area of Study: Clinical Psychology (APA/CPA accredited) Dissertation: Development and Validation of a New Scale for the Assessment of Psychopathy M.A., University of British Columbia (1987) Area of Study: Clinical Psychology (APA/CPA accredited) Thesis: Diagnosis of Psychopathy in a Forensic Psychiatric Setting B.A., University of British Columbia (1984) Area of Study: Psychology Awards Distinguished Contribution Award (2019) American Academy of Forensic Psychology Dean’s Medal for Academic Excellence (2013) Faculty of Arts and Social Sciences, Simon Fraser UniversitY Distinguished Achievement Award (2009) Association of Threat Assessment Professionals Career Achievement Award (2003) Section on Clinical Emergencies and Crises (Section VII) of the Society of Clinical Psychology (Division 12), American Psychological Association Jerome Fisher Memorial Lecture Award (2001) Department of Psychiatry and Langley
    [Show full text]
  • Versus Waiting List Control for Forensic Psychiatric Inpatients: a Multicenter Randomized Controlled Trial
    PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. https://hdl.handle.net/2066/221358 Please be advised that this information was generated on 2021-10-04 and may be subject to change. Journal of Clinical Medicine Article Virtual Reality Aggression Prevention Therapy (VRAPT) versus Waiting List Control for Forensic Psychiatric Inpatients: A Multicenter Randomized Controlled Trial Stéphanie Klein Tuente 1,2,* , Stefan Bogaerts 3,4 , Erik Bulten 5,6, Marije Keulen-de Vos 7 , Maarten Vos 1, Hein Bokern 2 , Sarah van IJzendoorn 4, Chris N. W. Geraets 1 and Wim Veling 1 1 Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; [email protected] (M.V.); [email protected] (C.N.W.G.); [email protected] (W.V.) 2 Forensic Psychiatric Center (FPC) Dr. S. van Mesdag, Helperlinie 2, 9722 AZ Groningen, The Netherlands; [email protected] 3 Department of Developmental Psychology, Tilburg University, Prof Cobbenhagenlaan 225, P.O. Box 90153, 5000 LE Tilburg, The Netherlands; [email protected] 4 Fivoor, Fivoor Science & Treatment Innovation, Kijvelandsekade 1, 3172 AB Poortugaal, The Netherlands; Sarah.van.IJzendoorn@fivoor.nl 5 Division Diagnostics Research and Education, Forensic Psychiatric Hospital Pompefoundation, Weg door Jonkerbos 55, 6532 CN Nijmegen, The Netherlands; [email protected] 6 Behavioral Science Institute (BSI) of Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands 7 Forensic Psychiatric Center (FPC) de Rooyse Wissel, P.O.
    [Show full text]
  • Virtual Reality Aggression Prevention Therapy (VRAPT) Versus Waiting List Control for Forensic Psychiatric Inpatients: a Multicenter Randomized Controlled Trial
    Journal of Clinical Medicine Article Virtual Reality Aggression Prevention Therapy (VRAPT) versus Waiting List Control for Forensic Psychiatric Inpatients: A Multicenter Randomized Controlled Trial Stéphanie Klein Tuente 1,2,* , Stefan Bogaerts 3,4 , Erik Bulten 5,6, Marije Keulen-de Vos 7 , Maarten Vos 1, Hein Bokern 2 , Sarah van IJzendoorn 4, Chris N. W. Geraets 1 and Wim Veling 1 1 Department of Psychiatry, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands; [email protected] (M.V.); [email protected] (C.N.W.G.); [email protected] (W.V.) 2 Forensic Psychiatric Center (FPC) Dr. S. van Mesdag, Helperlinie 2, 9722 AZ Groningen, The Netherlands; [email protected] 3 Department of Developmental Psychology, Tilburg University, Prof Cobbenhagenlaan 225, P.O. Box 90153, 5000 LE Tilburg, The Netherlands; [email protected] 4 Fivoor, Fivoor Science & Treatment Innovation, Kijvelandsekade 1, 3172 AB Poortugaal, The Netherlands; Sarah.van.IJzendoorn@fivoor.nl 5 Division Diagnostics Research and Education, Forensic Psychiatric Hospital Pompefoundation, Weg door Jonkerbos 55, 6532 CN Nijmegen, The Netherlands; [email protected] 6 Behavioral Science Institute (BSI) of Radboud University, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands 7 Forensic Psychiatric Center (FPC) de Rooyse Wissel, P.O. Box 433, 5800AK Venray, The Netherlands; [email protected] * Correspondence: [email protected]; Tel.: +31-628-779-213 Received: 23 June 2020; Accepted: 13 July 2020; Published: 16 July 2020 Abstract: Many forensic psychiatric inpatients have difficulties regulating aggressive behavior. Evidence of effective aggression treatments is limited.
    [Show full text]
  • A Preliminary Review of Cyber-Deception Factors: Offerings from a Systematic Review Anoushka P.A
    A Preliminary Review of Cyber-Deception Factors: Offerings from a Systematic Review Anoushka P.A. Anderson, Jo Bryce, Carol A. Ireland, * Jane L. Ireland ABSTRACT The current paper aims to provide a preliminary exploration of the characteristics associated with cyber-deception, by focusing on motivations for engagement and the psychological characteristics of those perpetrating such behaviour. It aims to further outline gaps in the literature and suggest what areas any potential model of cyber-deception could include to benefit future research. A systematic search of 11 databases was undertaken, with additional manual searching for relevant journals and sources. This was followed by data extraction and thematic analysis. A total of 21 studies were identified as meeting eligibility criteria. Six motivational themes emerged (i.e. acquiring attention and sympathy; a response to negative childhood experiences; preserving identity and presenting your ‘true’ self; to cause intentional harm and to pursue personal enjoyment; to exploit materially; deception as a stress-reliever in response to life strain), and one individual theme (i.e. perpetrator personality). Perpetrator motivation included a varied range of factors, with more static characteristics (i.e. personality) less well captured in the literature. Future research could determine if psychological differences are of value or if the area is better understood through consideration of more dynamic (motivational) factors. Key words: Cyber-detection; Motivation; Attention; Preserve identity; Harm; Enjoyment INTRODUCTION Deception is defined as a deliberate act with the intent to mislead (Buller & Burgoon, 1996), with online deception the use of Information and Communication Technology (ICT) to commit such acts (McGuire & * Corresponding author: [email protected] Salus Journal 88 Volume 7, Number 1, 2019 Dowling, 2013) and thus captured using the term cyber-deception.
    [Show full text]
  • Gender, Masculinity, Contemporary History and the Psychiatric Secure Estate: Back to the Future? Jason L. Powell and Paul Taylor
    Gender, Masculinity, Contemporary History and the Psychiatric Secure Estate: Back to the Future? Item Type Article Authors Powell, Jason; Taylor, Paul J. Citation Powell, J. L., & Taylor, P. (2015). Gender, Masculinity, Contemporary History and the Psychiatric Secure Estate: Back to the Future? World Scientific News, 22, 145-156 Publisher World Scientific News Journal World Scientific News Download date 26/09/2021 11:11:09 Link to Item http://hdl.handle.net/10034/592570 Powell, J.L., & Taylor, P. (2015). Gender, masculinity, contemporary history and the psychiatric secure estate: back to the future? Journal of World Scientific News, 22, 145-156. Gender, Masculinity, Contemporary History and the Psychiatric Secure Estate: Back to the Future? Jason L. Powell and Paul Taylor ABSTRACT In contemporary history, the use of gendered treatments for women with mental health issues in the psychiatric secure estate is an issue of major concern in Great Britain. This paper examines women and gender in the psychiatric secure estate from a structural analysis drawing influence from Connell’s (1987) theoretical and conceptual work on hegemonic masculinity. Bio-psychological approaches have almost dominated academic discussion in relation to women’s incarceration and there is a reflexive need to develop other sociological frameworks on hegemonic masculinity because dominant bio-psychological models have failed to identify underlying configurations which combine to oppress women whilst simultaneously reproducing consequences of masculinity and power within
    [Show full text]
  • Submitted in Partial Fulfilment of the Lancaster University Doctorate in Clinical Psychology November 2017 Doctoral Thesis: Ex
    Submitted in partial fulfilment of the Lancaster University Doctorate in Clinical Psychology November 2017 Doctoral Thesis: Exploring the experiences of staff working in forensic mental health settings. Rosemary Kirkham Doctorate in Clinical Psychology Division of Health Research, Lancaster University Statement of Total Word Count* Section Words Appendices Total (including abstracts, tables, figures and references) Thesis Abstract 237 - 237 Literature Review 8, 140 8, 433 16, 573 Research Paper 7, 981 6, 165 14, 146 Critical Appraisal 3, 168 549 3, 717 Ethics Section 5, 134 4, 003 9, 137 Appendices - 6, 796 6, 796 Total 24, 660 25, 946 50, 606 *Declaration: The total word length of this thesis conforms to the permitted maximum. Thesis Abstract Forensic mental health (FMH) is described as a complex and challenging specialism to work in. The experiences of staff working within FMH settings have important influences on the quality of care provided to patients. This thesis explored the experiences of both multidisciplinary staff and clinical psychologists. A meta-synthesis of international qualitative studies was conducted to explore the experiences of staff working in FMH settings. Sixteen papers were synthesised, revealing five themes: 1) The impact of safety; 2) Psychological and emotional impacts; 3) Trying to maintain control; 4) The double-edged sword of support; and 5) A special insight into humanity. The findings point to the importance of understanding how staff manage the impacts of working in FMH settings in order to develop effective support systems. Eight clinical psychologists were individually interviewed to explore their lived experiences of compassion satisfaction when working in UK forensic mental health settings.
    [Show full text]
  • Abstract Book
    ABSTRACT BOOK 1 Contents Symposia 3 Roundtables 67 Papers 76 Posters 263 2 SYMPOSIA Abstracts Sorted by rising #numbers 3 #260950 - Symposium - I9.2 Children of parents detained in secure hospitals Chair:PamelaTaylor, Cardiff University (United Kingdom) Symposium Abstract: Up to half of people admitted to secure forensic hospitals are parents, but little is known about their children's needs. We will present hospital survey data, results of systematic literature reviews and preliminary child interview work which collectively support ways forward in research and practice. Individual Abstracts: Children separated from a parent who is mentally ill, criminally violent and locked in a secure hospital: setting the scene Pamela J. Taylor,Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, UK People who are detained in secure psychiatric hospitals because of the risk they pose to others are generally of child bearing age. A few have killed a child, very few one or more of their own children. How many patients are, in fact, parents and what did this mean in practice? How many children are likely to be affected? What is the nature and quality of the evidence on child needs and interventions on their behalf? Such hospitals may provide appropriate visiting facilities and generally have a child safeguarding policy, which speaks mainly to the physical safety of the child. How many engage in any more active assessment, care or treatment initiatives for children of such parents? There is a substantial literature on children with parents who have a mental illness, covering issues as diverse as the genetic risk of the child developing a similar illness, developmental delays and the psychosocial impact, however most of this refers to children and parents living together in the community, often with the child having a career role.
    [Show full text]